Description of the attachment geometry of the anteromedial and posterolateral bundles of the ACL from arthroscopic perspective for anatomical tunnel placement

The anterior cruciate ligament (ACL) consists of an anteromedial bundle (AMB) and a posterolateral bundle (PLB). A reconstruction restoring the functional two-bundled nature should be able to approximate normal ACL function better than the most commonly used single-bundle reconstructions. Accurate tunnel positioning is important, but difficult. The purpose of this study was to provide a geometric description of the centre of the attachments relative to arthroscopically visible landmarks. The AMB and PLB attachment sites in 35 dissected cadaver knees were measured with a 3D system, as were anatomical landmarks of femur and tibia. At the femur, the mean ACL centre is positioned 7.9 ± 1.4 mm (mean ± 1 SD) shallow, along the notch roof, from the most lateral over-the-top position at the posterior edge of the intercondylar notch and from that point 4.0 ± 1.3 mm from the notch roof, low on the surface of the lateral condyle wall. The mean AMB centre is at 7.2 ± 1.8 and 1.4 ± 1.7 mm, and the mean PLB centre at 8.8 ± 1.6 and 6.7 ± 2.0 mm. At the tibia, the mean ACL centre is positioned 5.1 ± 1.7 mm lateral of the medial tibial spine and from that point 9.8 ± 2.1 mm anterior. The mean AMB centre is at 3.0 ± 1.6 and 9.4 ± 2.2 mm, and the mean PLB centre at 7.2 ± 1.8 and 10.1 ± 2.1 mm. The ACL attachment geometry is well defined relative to arthroscopically visible landmarks with respect to the AMB and PLB. With simple guidelines for the surgeon, the attachments centres can be found during arthroscopic single-bundle or double-bundle reconstructions

Listeria monocytogenes in Milk Products

peer-reviewedMilk and milk products are frequently identified as vectors for transmission of Listeria monocytogenes. Milk can be contaminated at farm level either by indirect external contamination from the farm environment or less frequently by direct contamination of the milk from infection in the animal. Pasteurisation of milk will kill L. monocytogenes, but post-pasteurisation contamination, consumption of unpasteurised milk and manufacture of unpasteurised milk products can lead to milk being the cause of outbreaks of listeriosis. Therefore, there is a concern that L. monocytogenes in milk could lead to a public health risk. To protect against this risk, there is a need for awareness surrounding the issues, hygienic practices to reduce the risk and adequate sampling and analysis to verify that the risk is controlled. This review will highlight the issues surrounding L. monocytogenes in milk and milk products, including possible control measures. It will therefore create awareness about L. monocytogenes, contributing to protection of public health

Complications related to deep venous thrombosis prophylaxis in trauma: a systematic review of the literature

Deep venous thrombosis prophylaxis is essential to the appropriate management of multisystem trauma patients. Without thromboprophylaxis, the rate of venous thrombosis and subsequent pulmonary embolism is substantial. Three prophylactic modalities are common: pharmacologic anticoagulation, mechanical compression devices, and inferior vena cava filtration. A systematic review was completed using PRISMA guidelines to evaluate the potential complications of DVT prophylactic options. Level one evidence currently supports the use of low molecular weight heparins for thromboprophylaxis in the trauma patient. Unfortunately, multiple techniques are not infrequently required for complex multisystem trauma patients. Each modality has potential complications. The risks of heparin include bleeding and heparin induced thrombocytopenia. Mechanical compression devices can result in local soft tissue injury, bleeding and patient non-compliance. Inferior vena cava filters migrate, cause inferior vena cava occlusion, and penetrate the vessel wall. While the use of these techniques can be life saving, they must be appropriately utilized

Pulmonary vascular changes associated with hypoplastic left ventricle syndrome

The lungs of ten newborn infants who died of hypoplastic left ventricle syndrome were studied by a morphometric technique that (1) determined the percentage wall thickness of injected pulmonary arteries, (2) determined the ratio between the number of alveoli per high-power field and the number of corresponding arteries, and (3) examined in detail the extension of medial smooth muscle to the vessels at the periphery of the acinus. The findings in the lung were related to the gross cardiac morphological changes and to echocardiographic and hemodynamic findings. The echocardiograms of eight neonates demonstrated small left ventricles. The aortic root was hypoplastic in seven and the left atrium was small in three of the eight. Pulmonary artery hypertension and elevation of the left atrial pressure were present in all infants in whom measurements were obtained. The mean percentage wall thickness of all vessels was greater in afflicted infants than in normal age-matched control subjects. There was a normal ratio between the number of alveoli per high-power field and the number of corresponding arteries, and all infants had extension of muscle to the peripheral vessels at the alveolar duct and alveolar wall levels. The pulmonary vascular abnormalities observed in the neonate with hypoplastic left ventricle syndrome may represent persistence of fetal vascular abnormalities associated with the abnormal fetal circulatory hemodynamics resulting from the malformation. These abnormalities may influence the success of surgery proposed for hypoplastic left ventricle syndrome.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/48096/1/246_2006_Article_BF02336435.pd

Validação de álbum seriado para promoção do aleitamento materno Validación de un álbum seriado para la promoción de la lactancia materna Validation of a flip chart for promoting breastfeeding

OBJETIVO: Validar um álbum seriado a respeito da autoeficácia em aleitamento materno quanto ao conteúdo e à aparência. MÉTODOS: Com base na versão traduzida da Breastfeeding Self-Efficacy Scale - Short Form foram elaboradas sete ilustrações e suas respectivas fichas-roteiro. Realizou-se a validade aparente (clareza/compreensão) e a validade de conteúdo (relevância) com base na avaliação de dez juízes. RESULTADOS: As considerações dos juízes foram acatadas em relação à clareza/compreensão. O Índice de Validade de Conteúdo foi 0,92 quanto às figuras e 0,97, quanto às fichas-roteiro, caracterizando o álbum seriado como uma estratégia válida. CONCLUSÕES: O álbum seriado pode ser utilizado nos diversos campos de atuação da enfermagem, inclusive no alojamento conjunto.<br>OBJETIVO: Validar un álbum seriado respecto a la autoeficacia de la lactancia materna en cuanto al contenido y la apariencia. MÉTODOS: Con base en la versión traducida de la Breastfeeding Self-Efficacy Scale - Short Form se elaboraron siete ilustraciones y sus respectivas fichas-guía. Se llevó a cabo la validez aparente (claridad/comprensión) y la validez de contenido (relevancia) mediante la evaluación de diez jueces. RESULTADOS: Las consideraciones de los jueces fueron acatadas en relación a laclaridad/comprensión. El Índice de Validez de Contenido fue de 0,92 en cuanto a las figuras y de 0,97, en cuanto a las fichas-guía, caracterizando el álbum seriado como una estrategia válida. CONCLUSIONES: El álbum seriado puede ser utilizado en los diversos campos de actuación de la enfermería, inclusive en el alojamiento conjunto.<br>OBJECTIVE: To validate a flipchart with respect to self-efficacy in breastfeeding, regarding its content and appearance. METHODS: Based on the translated version of the Breastfeeding Self-Efficacy Scale - Short Form, seven illustrations and their respective flipcharts were prepared. Face validity (clarity / understanding) and content validity (relevance) were performed based on the evaluation of ten judges. RESULTS: The judges considered the methods were successful in relation to clarity / understanding. The Content Validity Index was 0.92 as to the figures, and 0.97 as to the script, characterizing the flipchart as a valid strategy. CONCLUSIONS: The flipchart can be used in various areas where nursing is practiced, including shared patient rooms